For me, health care has always been about caring for the patient in front of me. Whether it was providing regular check-ups or helping families navigate the flu season, my focus was always caring for patients.

Throughout my entire career, patients were at the heart of my practice. I would expect the same to be true for most family doctors. However, parts of the health care system don’t work the same way. In my almost 40 years practicing family medicine, I have seen firsthand how the complexity of our health care system has made it more difficult for families and seniors to get care.

Sen. Ned Claxton

Mainers spend too much time, energy and most importantly, money, on health care. Going to the doctor is already stressful enough; between difficult medical terms, complicated paperwork and general anxiety over a potential diagnosis. Surprise fees, late bills and impossible to understand health care costs only make matters worse. Patients deserve better.

This year, I am introducing legislation to protect patients from abusive and confusing billing practices.

It doesn’t take a doctor to recognize that the status quo is not working for Maine families. When a family receives an unexpected medical bill more than six months after a procedure or treatment, it undermines their financial security. The same is true for an “out-of-network” bill. With these bills, Patients don’t even realize large medical bills are a possibility and have no idea how much the visit can cost. In some cases, these “out-of-network” bills follow emergency situations where even the most informed patients have no say in the matter. At such times, families are focused on their loved ones; it’s only later that they end up getting a bill they don’t understand.

These abusive billing practices and obscure fees are at odds with the oath we take as doctors. It goes against our values and undermines our mission. My proposal is about putting patients first, making sure they are treated fairly and are able to make informed decisions.

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My bill requires health care systems and providers to be upfront with patients about fees. It requires “out-of-network” providers and specialists to alert patients about costs prior to their visit. Finally, it requires insurance companies to bill patients within six months of a procedure or visit. These are simple changes that are long overdue.

People don’t buy groceries, a house or a car without knowing the price. The same should be true with something as important and expensive as health care.

I began working on this legislation after hearing from former patients and constituents. It recently hit close to home when I was blindsided by a $600 medical bill for care I had received last year. That’s a lot of money. It adds up to a tank of propane or a good chunk of a mortgage payment.

I had thought Medicare had covered most of the bill. While I believe that the provider deserves to be paid, I also believe that I should’ve received a heads up so I could budget accordingly. I imagine most people would feel the same.

For many Mainers, all it takes is one large medical bill to threaten their financial stability. Without enough cash reserves to fall back on, many people resort to borrowing money, putting it on a credit card or simply ignoring it. It’s only a matter of time before the delinquent notices and phone calls come and your credit score drops. It’s a no-win circumstance on the way to a big financial hole. Maine can and should be better than this.

For me, practicing health care was personal. When you practice medicine in a small tight-knit community, your patients aren’t just people you see once a year for a check-up, they’re your friends and neighbors. These are people you run into at the grocery store, who coach your son’s baseball team or maybe teach at the local school. When you practice family medicine, you build relationships that span generations. I’ve had the privilege of being there to welcome new members into the family or say goodbye to beloved matriarchs.

Throughout my career, I did everything I could to provide them with the best possible care. The last thing I want to see is the patients I know and love going bankrupt for going to the doctor.

As a physician, I took an oath to put patients first. It’s about time our health care system did too. With the Patients First package of bills, Maine lawmakers can help make that happen.

Sen. Ned Claxton is a retired family physician currently serving his first term in the Maine Senate, representing Senate District 20, the communities of Auburn, Minot, Mechanic Falls, New Gloucester and Poland.


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